The plicae are remaining synovial septa in adult life which existed in early fetal life. The suprapatellar plica separates the suprapatellar pouch from the knee joint. The plica ksyndrome has clinical significance, which has been occasionally
overlooked, but the pathophysiology of symptomatic plicae may be hard to explain.
To evaluate the cases in 15 patients who had complained of vague pain around the knee and found total septum of suprapatellar plica at the arthroscopic examination from September 1991 April 1993. The follow-up period was from 6 months to 2 years
and 1
month.
@ES The results were as follows:
@EN 1. The age of patients ranged from 24 to 56 years old, the average being 36 years old. There were 10 females (66.l7%) and 5 males 933.3%).
2. The symptoms were chronic mild knee pain which was aggrdavated at longsquatting and long-standing position and others were recurrent swelling in 6 (28.6%), instability or giving-way in 5 (23.8%), and catching or clicking in 3 cases (14.3%).
There
was bilateral involvemnet in 9 patients (60.0%), who had similar symptoms on both knees.
3. The objective findings include palpable band on superomedial side in 9 (429%), audible snapping in 6 (28.6%), local tenderness in 4 cases (19.0%) and no significant abnormal findings in the laboratory.
4. The radiographic findings were normal in 17 (81.0%), sclerosis of articular surface of the patella in 2 (9.5%), malalignment in 1 (4.8%), and mild degenerativge change in 1 cases (4.8%). There was increased uptake around patellofemoral joint
at
radioisotope scanning and relatively small suprapatellar bursa at the conventional arthrogram.
5. At the arthroscopic findings, there were suprapatellar plicae with total septum in 19 (90.1%) of 21 cases and associated lesions were presented as meniscal tears in 3(14.3%), loose body in 1 (4.8%), and discoid meniscus without tear in 1 case
(4.8%).
6. The complete plicae were surgically excised under the arthroscopic control in 19 cases and the results showed complete relief of pain in 12 (63.2%), syjmptomatic improvement in 4 (21.1%), no change in 3 (15.8%), and none of worsening after 13
months
follow-up.
In our opinion, the complete suprapatella plica is clinically significant in patients who had equivocal diagnosis about knee problems and further studies for the pathophysiology of complete suprapatellar plica are needed.
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